Sunday, September 30, 2018

The Quiet Ones

The Quiet OnesThe Quiet Ones by Glenn Diaz

My rating: 5 of 5 stars


The book takes us deep into the streets of Manila, its ambitions and dreams, even if it takes a crime to achieve them. The language is masterful, the characters so palpable you can hear them speak. This is a Filipino novel written in English, and a great novel, whichever way you see it.

Write some more books like this, please, Mr. Diaz!



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Sifting through Scripture, a Christmas greeting this September

Pastor Bob has started the series on Matthew called "Oh, Worship the King." It's the sixth lesson on this series, and given the rate at which we progress, it may take another five years to the final sermon. When I began college in 2004, the series on the Book of John was about a year old, give or take, and we would be finished with it by the time I graduated and started medical school. During medical school and my internal medicine residency training, the pulpit series was on the Book of Acts. We just finished with Acts this year.

The Filipino word is himay, roughly translated to sift through--a slow, meditative inspection, analysis, and interpretation of the biblical text. This is what Pastor Bob, and other faithful pastors, are doing in their own local churches. I find it particularly useful in that I am forced to think along the lines of thought of the book's writers (the Bible tells us that these words are ultimately God's), reading the words in their proper cultural context, and so on. All Christians are students of theology, and I feel challenged and encouraged to receive that treatment in church.

I love how there's almost always something new to discover in Scripture. The preaching today was on Matthew 2: the visit of the magi to Jesus. Careful inspection of the text reveals that during the visit, Jesus would have been two years old already, and Mary and Joseph had moved out of a manger, into their own home. It makes our Filipino belen historically false, but I like its imagery nonetheless.

The Christmas story is a beautiful story that cuts right at the heart of the Christian faith. It is a poetic reality of the glorious God becoming man, only to be born in a manger and to die on the cross. It is the harshest humiliation but the most glorious demonstration of love. John Calvin wrote:

“We see that our whole salvation and all its parts are comprehended in Christ [Acts 4:12]. We should therefore take care not to derive the least portion of it from anywhere else.
If we seek salvation, we are taught by the very name of Jesus that it is “of him” [I Cor. 1:30].
If we seek any other gifts of the Spirit, they will be found in his anointing.
If we seek strength, it lies in his dominion; if purity, in his conception; if gentleness, it appears in his birth. For by his birth he was made like us in all respects [Geb. 2:17] that he might learn to feel our pain [cf. Heb. 5:2]. (emphasis mine)
If we seek redemption, it lies in his passion;
if acquittal, in his condemnation;
if remission of the curse, in his cross [Gal. 3:13];
if satisfaction, in his sacrifice;
if purification, in his blood;
if reconciliation, in his descent into hell;
if mortification of the flesh, in his tomb;
if newness of life, in his resurrection; if immortality, in the same;
if inheritance of the Heavenly Kingdom, in his entrance into heaven;
if protection, if security, if abundant supply of all blessings, in his Kingdom;
if untroubled expectation of judgment, in the power given to him to judge.
In short, since rich store of every kind of good abounds in him, let us drink our fill from this fountain, and from no other.” -- The Institutes, Book II, Chapter XVI

With that, and given the fact that we start our celebration early in the Philippines, I wish you a Merry Christmas!

Saturday, September 29, 2018

September is ending

I bump into colleagues during rounds and often get asked if I still blog. My answer is always that yes, I still do, but it's hard to make time. These colleagues are probably too busy with their own lives to even bother reading blogs, let alone mine, and their dose of online presence is probably limited to Facebook, Instagram, and PubMed. Still, it touches me that they remember.

I force myself to remember to write here as often as I can, if only to exercise the habit of organizing my thoughts into words. The reason for my less than frequent posting is that I already spend most of the day writing--but of the more technical kind, as in medical charting or drafting research proposals. More often than not, however, I find that I have nothing to say. Sure, I can write about my life, but will that elevate the level of discourse among my supposed readers?

Nevertheless, I find that writing is therapeutic. This here is a space where I can share my thoughts freely. My thoughts are not necessarily original: I post excerpts of books and websites, and perhaps I should post more about oncology and internal medicine, directed both to the laymen (and -women) and the specialists. The lack of structure, of a general theme, of this blog is intrinsic to its nature. I write whatever pleases me and wish that it pleases the reader as well.

September is about to end, and what a year this has been for me: a rollercoaster of events, both personal and professional. During many moments I wondered if I would ever get through, but by God's grace, I am where I am. New residents are about to join in our fold at the hospital, and I'm just a few months away from the beginning of my final year of clinical fellowship.

Friday, September 28, 2018

The Lord's Prayer is subversive

Dr. Albert Mohler contrasts the Serenity Prayer ("God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference") and the Lord's Prayer.

In many ways, the Serenity Prayer is the model prayer for a post-Christian society. It says nothing about the character of God, the plight of man, the need for redemption, or the nature of the Gospel. The Serenity Prayer is nothing more than a generic prayer for a people with generic religious convictions.

The Lord’s Prayer, however, is doctrinally robust, theologically deep, and anything but serene. The Lord’s Prayer is anything but tame.

Dr. Mohler also calls The Lord's Prayer "subversive."

So, what are we asking when we say “your kingdom come”? We are asking for something wonderful and something dangerous all at the same time:

  • We are praying that history would be brought to a close.
  • We are praying to see all the nations rejoice in the glory of God.
  • We are praying to see Christ honored as King in every human heart.
  • We are praying to see Satan bound, evil vanquished, death no more.
  • We are praying to see the mercy of God demonstrated in the full justification and acquittal of sinners through the shed blood of the crucified and resurrected Christ.
  • We are praying to see the wrath of God poured out upon sin.
  • We are praying to see every knee bow and every tongue confess that Jesus Christ is Lord to the glory of God the Father.
  • We are praying to see a New Jerusalem, a new heaven, a new earth, a new creation.

Saturday, September 22, 2018

In my mind



Jon Bryant's Carolina is stuck to my head. It's a song full of longing, distance, and detachment, and it's sobering. Days find me wishing I were somewhere else—at home, for example—but reality finds me back and clutches me with the reassurance that I am where I should be. Travel breaks the monotony of daily life, but so does music and books.

In my mind, I'm going to Carolina
Can't you see the sunshine?
Can't you just feel the moonshine?
And ain't it just like a friend of mine hit me from behind?
Yes, I'm going to Carolina in my mind

Thursday, September 20, 2018

Wednesday, September 19, 2018

Sunday, September 16, 2018

Steroids decrease efficacy of PD-1/PD-L1 inhibitors in NSCLC

Dr. Matthew Stenger, via The ASCO Post:

In a study reported in the Journal of Clinical Oncology, Arbour et al found that baseline treatment with corticosteroids was associated with poorer efficacy of programmed cell death protein 1 (PD-1) or programmed death cell ligand 1 (PD-L1) inhibitors in patients with non–small cell lung cancer (NSCLC).

Furthermore,

The investigators concluded, “Baseline corticosteroid use of ≥ 10 mg of prednisone equivalent was associated with poorer outcome in patients with non–small cell lung cancer who were treated with [PD-1/PD-L1] blockade.”

Baseline corticosteroids were associated with decreased overall response rate, progression-free survival, and overall survival with PD-(L)1 blockade.

What's the clinical impact for oncologists? Must we then avoid corticosteroids entirely? The authors recommend its "prudent" use.

Monday, September 3, 2018

Visiting Nella Sarabia's new optical shop at Acacia Dorm, UP Diliman

Composed September 3, 2018, but I've just only realized it was saved in drafts and not posted publicly. 

My commute to UP Diliman was brief. I took the bus, hailed a UP-Philcoa jeepney, and alighted at what used to be the UP Shopping Center, home to my favorite karinderya and optical shop, a block away from Yakal dorm where I used to live. The karinderya did not survive the fire, but the optical shop did. The new location was right across the street—the new dorm complex, Acacia, at the back of Kalayaan. Gone are the days when I bumped into familiar faces—classmates, groupmates, dormmates, labmates, my tsinelas-and-shorts UP community—busy with the same things as I was. An essay that needed printing, a provincial urge to munch on the acidity of a green mango, half-cut in the middle, dabbed with rock salt and chili.

The area at 2 pm was foreign and familiar. I savored all these, what used to be my every day walk, the treelined streets and the educated banter in the background.

Dr. Nella Sarabi, having emerged from lunch break, greeted me with smiles and a compliment. “Those are nice frames—are those from the shop?” she asked, to which I answered, “Of course.” Going to her shop reminds me of time that had passed since she had introduced me to the world of eyeglasses when I was in second year college. She asked about me and my brother; she remembered our names, picking them from her mental cloud of customers, her smile widening as she learned about the things I do. Cancer. Rounds. PGH.

I visited her to have sunglasses made. I made a shortlist, eventually zeroed in on the metal, bronze frames. Dr. Sarabia approved. I went through the ritual of having my eyes checked. “Read line seven,” she said. I knew the answer, even with eyes closed—D-E-F-P-O-T-E-C.
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